By Melissa Yi
Hi, I’m Dr. Melissa Yi, emergency physician and the author of GRAVEYARD SHIFT, which debuted November 1st.
Have you ever wondered if the website Reddit is for real? Today I’ll dissect their thread, “What are some of the most common proverbs/sayings in emergency medicine?” (https://www.reddit.com/r/emergencymedicine/comments/diwe1h/what_are_some_of_the_most_common_proverbssayings/?st=k20tlot2&sh=fd139cc6#bottom-comments).
10. “Emergency medicine is show business for ugly people.”
False. I’ve never heard this saying. Maybe I don’t want to hear this saying.
“Does this refer to the patients or doctors?” asked someone.
“Yes,” a third person replied.
So right out of the gate, we have an insult to everyone! I would say that actually, doctors in general are pretty good-looking, although less so after a night shift. Same for our patients. Hard to look runway-ready when you’re admitted on a stretcher for 72 hours. Moving on.
9. “Every female is pregnant until proven otherwise.”
Yes! I drive the nurses crazy when I order pregnancy tests on almost everyone with a uterus, but you don’t want to miss an ectopic (tubal) pregnancy, which can rupture and kill the woman. You also don’t want to radiate a fetus with a CT scans or even X-ray. Take the time to order the pregnancy test.
8. “You’re not dead until you’re warm and dead.”
Absolutely true. If the patient is hypothermic (too cold), the heart and lungs can stop, only to revive after you warm them up to 30-32 degrees Celsius. I used this precept for HUMAN REMAINS, when Dr. Hope Sze found a body in the snow with a garbage bag over its head.
7. “If someone tells me “I feel like I’m gonna die” or please don’t let me die”… you best believe I have all my eyes including a third on them.”
True. Usually people don’t tell me when they’re going to die. They’re unconscious and not perfusing their brains. But once in a while, they do. And I listen. ‘Cause I don’t want them to die.
6. “What’s the most commonly missed fracture?” “The second one.”
Right. When we get X-rays of the cervical spine, for example, we’re instructed not to get too excited if we spot a fracture, because we might overlook the second one. Because it’s not good enough to break your neck; you could easily break it in two places. Or more!
5. “Less than 8, intubate.”
Yep. If your Glasgow Coma Scale is 8 or less, you’re too comatose to be trusted to breathe on your own. We will intubate you, which means sticking a tube down your throat so we can breathe for you, usually with a ventilator, but my smaller hospital doesn’t have one. A nurse or has to manually bag (push on the oxygen bag) for them.
4. “The more chief complaints / positive ROS questions you have the less likely I am to find anything.”
So true. If you come in saying, “I have a headache, and my chest hurts, and my genitals itch, and my ears are blocked, and my nose is crooked, and my urine is really dark, and my belly button looks funny,” it takes up a lot of my time, but I probably won’t find any serious diagnosis anywhere.
3. “There are old ER docs, there are bold ER docs, but there are no old bold ER docs.”
True. I was more of a confident “cowboy” when I first graduated. Since then, I’ve been surprised and sometimes humbled by infections, fractures, heart attacks, blood clots, and cancer when the patient looked fine and had normal vital signs or initial tests. So now I order some tests even if I fully expect them to be negative. I could be right 98 percent of the time, but I don’t want to miss that 2 percent. That 2 percent could be my daughter.
2. “You get what you get and you don’t get upset.”
True! The secret to happiness in the ER, and maybe in life.
If the patients are drunk and disorderly, you deal with it.
If there’s a mass casualty, you deal with it.
Yelling and gnashing your teeth might feel good for a few minutes, but it doesn’t end up adding anything except more volume.
1. “Bad things happen to nice people.”
Yes. It all comes down to this. Life isn’t fair. I’ve seen infants with cancer and philanthropists in intensive care while drunk drivers literally walk away.
That’s part of the reason I enjoy writing Hope Sze novels. She’s a resident doctor who solves crimes. She sees terrible things—Graveyard Shift starts off with someone trying to strangle Hope with her own stethoscope—but she doesn’t give up, she doesn’t give in, and she outsmarts the killers every time.
So please join Hope on her latest thriller. You can snap up a free copy with the code GRAVEYARD100 at https://www.kobo.com/ca/en/ebook/graveyard-shift-14.
The first three books will debut in audio starting TODAY, and the entire series can be relished as ebooks or in trade paperback.
Thanks for tuning in, and stay healthy!
Melissa Yi wields a stethoscope and a scalpel as an emergency physician. She also pens the Hope Sze medical thrillers, which have been named one of the best Canadian suspense books by the Globe and Mail, CBC Books, and The Next Chapter. Yi was a finalist for the Arthur Ellis Award for best crime story in Canada and shortlisted for the Derringer Award for the best short mystery fiction in the English language. Sometimes, she sleeps.